Critical Incident Reporting and the Discursive Reconfiguration of Feeling and Positioning
Issued Date: 28 Aug 2013
Abstract
This article analyses the emotional and generic dimensions of critical incident reports. These incident reports have been selected from the specialty of retrieval medicine; that is, a specialized service that transports patients from distant accident sites to hospitals. With its focus on emergencies in distant locations, this area of medicine and the care it provides is a hothouse for procedural difficulties, medical complications and, therefore, emotive language. The analysis demonstrates, firstly, that these reports can contain a range of evaluative expressions, including personal and depersonalized affect, interpersonal and normative udgements, and assessments of the functionality of objects. Secondly, these evaluations frequently harbour a tension between informal (private, emotional, self-oriented) and formal (public, depersonalized, formalized) discourse. Thirdly, the overall structure of incident reports is such as to effect a complex discursive transformation from personal sentiments into organizational assessments and solutions. The article concludes that incident reporting is an important postbureaucratic technique, in that it creates a space where clinicians are invited to link experiential dilemmas to service redesign strategies, and display their commitment
to the ethos and practices of organizational improvement.
to the ethos and practices of organizational improvement.
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